What is the role of prebiotic supplementation during gestation and lactation? 

Early nutrition and the development of the gut microbiome is understood to have positive effects on immune and metabolic development in early life. It is thought that early nutrition could have a lasting effect on health because the development of the gut microbiome, immune and metabolic systems can be important in determining health factors in later life1. From preclinical trials, it becomes clear that there is a relationship between the gut microbiome and behaviour2. Not only does the gut microbiome influence metabolic and immune development in the critical time of early life, but it has also been shown to help shape cognitive development3.  

Interplay between the gut microbiome and the brain 

A bi-directional relationship between the gut and the brain is characterised through neural, endocrine and inflammatory communication and is thought to be modulated by the gut microbiome. This is known as the gut-brain axis4. Reduction in anxiety and the effect that the gut microbiome has on behaviour is due to the immune modulatory effect. A reduction of inflammation is believed to modulate the hypothalamic pituitary axis (HPA), and it is this impact on the gut-brain axis that can regulate behaviour or anxiety4.

In a preclinical model, it was demonstrated that prebiotic supplementation, with specific galactooligosaccharides (GOS), reduced post-inflammation anxiety, which supports the evidence for the gut microbiome being involved in normal brain function5. There is further evidence that the gut microbiome plays a role in stress, anxiety and depression from research on probiotic supplementation, using a probiotic combination of lactobacillus and bifidobacteria6. The consumption of probiotics led to a reduction in inflammation and modulated communication with the central nervous system (CNS) seen by lower levels of neurotransmitters. Whilst a lot of the research on anxiety and reducing psychological distress using the gut microbiome involves preclinical trials, there is evidence that it could be used alongside other therapies due to the anxiolytic effect6

What do the studies tell us? 

In a healthy population of subjects, with an average age of 23.69 years, Bimuno® GOS supplementation was associated with lower waking cortisol levels and altered attentional bias towards a more positive stimulus. This is consistent with preclinical trials on probiotics having an anxiolytic effect7. Results of the study suggest that prebiotic supplementation, specifically Bimuno GOS, could modulate the HPA activity, since waking cortisol is considered to be an appropriate measure for this. Additionally, attention shifted more towards a positive stimulus than a negative stimulus, suggesting that the gut microbiome interventions could be utilised for information processing and behavioural purposes if they can be proven clinically beneficial7

Furthermore, probiotic supplementation during the second half of gestation alters cellular structure of the infant’s brain as demonstrated in a preclinical model, which may be associated with behavioural outcomes later in life8. Maternal probiotic supplementation has also reduced certain anxiety-like behaviours and improved emotional learning in females. It seems clear that the maternal gut microbiome can alter gene expression in offspring and therefore, maternal nutrition can influence development of offspring through the gut microbiome8.  

Child

Application of maternal prebiotic supplementation 

Very recently, a preclinical study investigated prebiotic supplementation with Bimuno GOS during gestation and lactation. The supplementation was compared to a placebo and offspring behaviour was tested at weaning age and adulthood9. The maternal gut microbiome and relationships with the offspring’s gut microbiome, brain and behaviour were explored using faecal microbiome composition and metabolites analyses9

Interestingly, exploratory behaviour of offspring at weaning age was increased in those with maternal Bimuno GOS supplementation. Postnatal Bimuno GOS supplementation, during breastfeeding, increased levels of faecal butyrate and propionate; short chain fatty acids (SCFAs) that are known to be beneficial to health9. In female offspring, perinatal supplementation of Bimuno GOS was associated with increased cortisol glutamate receptor subunits, reduced anxiety and increased social preference9

Breastmilk composition may account for the differences in brain-gene expression and behaviour in offspring in the Bimuno GOS group. Maternal prebiotic intake, particularly during breastfeeding, could represent an opportunity to safely modulate infant microbiome. The supplementation during lactation may reduce behavioural adaptations in response to early-life inflammation and improve social interactions in adulthood9.  

In conclusion  

There is compelling evidence for an ‘imprinting’ effect that maternal nutrition has on offspring, and now, maternal supplementation with prebiotics and probiotics shows evidence for modulating behaviour of the offspring that includes reduction of anxiety in later life. More research is required in humans, but the benefits that the gut microbiome can have on mother and offspring appears to be a highly promising avenue for future exploration.  


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